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, � <br /> SEPTIC SYSTEM APPROVAL <br /> --0� <br /> ,�+c►rro ctu� <br /> ''������' '� ����`:,, ��oNo coP ��rnvo co� <br /> ,� � � '' <br /> �� �� �� ��� C ITY of ORONO <br /> �! �' x � ,� <br /> , �. <br /> � �r�`,, , �r ,�' Municipal Offices <br /> �.� ` '.' ' `�+"�Gj� SVeet Address: Mailing Address: <br /> � �'��kEBH� 2750 Kelley Parkway P.O. Box 66 <br /> = Orono, MN 55356 Crystal Bay, MN 55323-0066 <br /> O�vner M►�QK L��sc,� Phone (Home) �f�2-��33 (work) -- <br /> Address 3�(� Nc,�tti A-;e w� L�nC City w�o UNd State /`1 nf Zip 5536 y <br /> Site Evaluator 5 w������.p State License# Phone# ��t Z-S�SS <br /> Type of Establishment: Single Family X Multi Family <br /> Commercial /�c Garbage Disposal Yes� No <br /> No. Potential Bedrooms � Est. Gallons Per Day `-ISO <br /> Water Meter Required: Yes, No� Soil Sizing Factor , b F�F� _ <br /> Perc Rates P-1 Z.£� P-2 2y P-3 2� P-4 P-5 P-6 - <br /> Restricting Layer Depth B-1� B-2 y�" B-3 N$" B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard �C: Experimental Alternative <br /> Pressurized Mound System� �,J/�I t:(LT�I�l�'l�� At-Grade System <br /> Gravity Trenches System Pressurized Trench System <br /> Gravity Trenches W/Lift Pressurized Bed System <br /> Holding Tank W/Alarm <br /> Septic Tank Size i2$o 0�0 # of Tanks � Lift Tank Size �" <br /> Pump Brand --- GPM - Head — <br /> Treatment System: � <br /> Minimum 7 5 � Square Feet with � inches of rock belo�v pipe <br /> Type of coverin� Fabric Other� <br /> THIS IS NOT A PERMIT. This is a design approval form which must accompany the site plan. <br /> A permit must be issued to a licensed septic contractor prior to installation. <br /> NOTICE TO INSTALLERS: Any changes to the approved plans must have prior approval of the <br /> inspector (249-4600) Call for inspection 24 hours in advance. <br /> ALL DRAINFIELD AREAS MUST BE FENCED OFF prior to building site excavation and <br /> fencing must remain in place until final site gradina: Approval to pour footings will not be granted <br /> until the Inspections Department has verified the primary and alternate sites are protected. <br /> NO VEHICULAR TRAFFIC OF ANY KIND is allowed within 20' of tested drainfield sites ever. <br /> ACCEPTED�_ DENIED By the City of Orono subject to existing regulations and <br /> the following conditions: Mb�h+w„� ,��1 M�r;w+u,� 5���+(o.�c�s S�s�Pn� �'Gtr� N L► <br /> - �' � �wl 2'� i nc►�� <br /> , <br /> By: Qtt.�c� �o-Zs—oa <br /> �M�p��N�� Chns Pence, On-Site Systems Manager <br /> ��BEDR04MS. ANY INCREASE IN NUMBER <br /> OF BEDROOMS tNVAUDATES TFiIS DESlGN. � <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />